Genderspecific Conditions Puberty

In prepubertal children, boys and girls have similar rates of OSA (64,65). OSA in children is usually due to anatomic upper airway obstruction from tonsillar hypertrophy, although with the rising epidemic of obesity, increased body weight is also associated with development of OSA in children. The divergence in prevalence of OSA occurs only after puberty (66), supporting the role of the sex hormones estrogen, progesterone, and testosterone in modifying the risk of developing OSA. After menarche, upper airway dilator muscle activity fluctuates over the monthly cycle (46), potentially affecting upper airway patency. In healthy women, upper airway resistance is increased in the follicular phase of the menstrual cycle, compared to the luteal phase, during wake and stage 2 NREM sleep (67).

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